PURPOSE: The purpose of this study is to evaluate the relationship between developmental lumbar spinalstenosis and its BMD value by using the single energy quantitative CT(SEQCT). MATERIALS & METHODS: Eighty normal volunteers(20-60years) were selected as a control group and 28 patients with developmental lumbar spinal stenosis were selected as a disease group. The two groups were divided into a younger (20-39years) and an older subgroup(40-60 years), and were further divided into male and female subgroups. All the cases showed no evidence of metabolic disease, fracture, herniated nucleus pulposus, degererative spondylosis, infectious disease, tumors orhad no history of absolute immobilization of more than two weeks. All underwent lumbar spine CT and SEQCT. We measured bone mineral density(BMD) at the cancellous bone of L1, 2, 3 and obtained the mean and its one standard deviation, and compared the data between each subgroup of the control and the disease group using ANOVA. RESULTS: There was a significant low BMD value in the younger male patient subgroup compared with the control subgroup(P<0.05). CONCLUSION: Developmental lumbar spinal stenosis in a young male may be a factor of decreasing BMD of the body of the spine.
Communicable Diseases ; Female ; Humans ; Immobilization ; Male ; Spinal Stenosis* ; Spine ; Spondylosis

OBJECTIVES: To study the distributions of pH and gas values in umbilical arterial(UA) blood of normal newborns following uncomplicated pregnancies and vaginal births. Methods: In 457 consecutive normal term infants who were born between March 1995 and June 1998, we examined the UA pH and blood gas values obtained immediately following delivery. Maternal inclusion criteria were defined as an uncomplicated singleton pregnancy and a normal full term spontaneous vaginal delivery. And also neonatal inclusion criteria were defined as a normal intrauterine growth appropriate for gestational age without any malformations and Apgar score of 7 or more at both one and five minutes after birth. Umbilical artery blood samples were collected at each birth and were evaluated for pH, carbon dioxide pressure (PaCO2), oxygen pressure (PaO2) and actual bicarbonate. RESULTS: Histogram of UA pH value resemble normal distribution curve. The lowest UA pH was 7.04 and the 10th percentile value was 7.23. The median UA pH was 7.31 and 5% was below 7.20. The lowest UA PaO2 was 4.6mmHg and the 10th percentile value was 11.5mmHg. The highest UA PaCO2 was 67.2mmHg and the 90th percentile value was 56.5mmHg. The lowest bicarbonate value was 13.2mmol/L and the 10th percentile value was 18.4mmol/L. CONCLUSION: The distributions of the UA pH and gas values of the collective of normal newborns were illustrated. None of the UA pH was below 7.0.
Apgar Score ; Blood Gas Analysis* ; Carbon Dioxide ; Gestational Age ; Humans ; Hydrogen-Ion Concentration ; Infant ; Infant, Newborn* ; Oxygen ; Parturition ; Pregnancy ; Umbilical Arteries*

No abstract available.
Lung Injury* ; Lung* ; Paraquat*

STUDY DESIGN: A retrospective review of the patients who have a fixation failure of instrumentalion for the spinal fusion in lumbar region. OBJECTIVES: To assess the incidence and different types of the mechanical failure of fixation and to evaluate their managements and their influences on the progression of a spinal fusion and to the clinical outcomes. SUMMARY OF LITERATURE REVIEW: Most of the spine surgeons have been experiencing the mechanical failures after instrumentations for a spinal fusion, eden though the incidence is decreasing with a modification of the implants. Reports on this problem are sporadic in conjunction with the other topics, rarely focusing on their management and their influences on the final outcomes. MATERIALS AND METHODS: 338 consecutive patients who had a lateral fusion in the lumbar region with an instrumentation of pedicle screws and rods, mostly with decompression, were reviewed to analyse the fixation failures of instrumentation after surgery. RESULTS: There were 26 patients (7.7%) who had the fixation failures of instrumentation, in terms of loosening around the pedicle screws in 18 patients (5.3%), the breakage of the pedicle screws in fide patients (1.5%), and the migration of a rod in three patients (0.9%). They were managed by prolonged use of brace and ergonomic back cares. Even with the fixation failures, 19 patients (73.1%) disclosed solid union uneventfully, but one patient had re-operation to obtain solid fusion. The final outcomes were satisfactory in 22 patients (84.6%), including four of six patients who had pseudoarthrosis. CONCLUSIONS: The fixation failure of instrumentation after a spinal fusion in lumbar region was not rare, but the progression of a spinal fusion usually quite well achieved and the final outcomes were not so bad, even with the implant failures and pseudoarthrosi s. Except for the persistently symptomatic pseudoarthrosis, only a prolonged use of brace and the ergonomic back cares are recommended for symptomatic patients.
Braces ; Decompression ; Humans ; Incidence ; Lumbosacral Region* ; Pseudarthrosis ; Retrospective Studies ; Spinal Fusion* ; Spine

In a conservative treatment of lumbar disc herniation, authors customarily had included the flexion exercise untill 1991. Thereafter, the extension exercise started to be included for the selected patients and this study was designed to assess the clinical outcome of the extension exercise compared to the flexion exercise in the conservative treatments of lumbar disc herniations. 55 consecutive patients (31 males and 24 females having ages ranging from 19-68 years with a mean of 37.2) were included in this prospective study. Criteria for inclusion in this group were: 1. Contained herniations of a single lumbar disc, documented by CT or MRI; 2. no other concurrent spine pathology; 3. conservative treatments with an uniform program including the extension exercise; 4. follow-up for a minimum of one year. For comparison with this prospective group, another 62 consecutive patients (36 males and 26 females having ages ranging from 17-63 years with a mean of 35.7) were selected who were treated during 1991 with flexion exercise before this study was designed and who were matched with the designed criteria except for the direction of exercise. Apart from the therapeutic exercise, the conservative treatments also included medication, physiotheraphy, epidural injection, and back school in the both groups uniformly. The clinical outcome of the extension exercise group indicated that 28 (50.9%) patients excellent, 23 (41.8%) patients good, three (5.5%) patients fair, and one (1.8%) patient failed outcomes. In the flexion exercise group, there were 23 (37.1%) excellent, 27 (43.5%) good, seven (11.3%) fair, and five (8.1%) failed outcomes. From these results, it would seem to follow that the extension exercise group had superior clinical outcome compared to the flexion exercise, i.e. higher excellent and good outcomes (92.7% vs. 80.6%) and lower poor and failed outcomes (7.3% vs. 19.4%), respectively, Moreover, the excellent outcome in terms of full recovery without any pain and disability was more common in the extension exercise group (50.9% vs. 37.1%). A better clinical outcome was obtained in the extension exercise group of patients who were younger than 40 years and who had a history of three months or less compared with those who were older and had longer history of disease. The sizes of disc protrusion did not affect the clinical outcome. In conclusion, we would recommend that the extension exercise, instead of the flexion exercise, should be included in the conservative treatment of a contained herniation of lumbar disc for a better clinical outcome.
Female ; Follow-Up Studies ; Humans ; Injections, Epidural ; Magnetic Resonance Imaging ; Male ; Pathology ; Prospective Studies ; Spine

No Abstract Available.
Arthroplasty* ; Congenital Abnormalities* ; Humans ; Knee*

No Abstract Available.
Arthroplasty* ; Knee*

Tuberculosis of the thyroid gland is extremely rare, with only a few reported cases in the recent literature. The diagnosis is based entirely upon the histological picture of the tubercle, which consists of aggregates of mononuclear epithelial cells, giants cells, and a border of lymphocytes. Tuberculosis may involve the thyroid gland in two main forms. One common form spreads to the thyroid as part of generalized dissemination, and the other one is focal or caseous tuberculosis of the thyroid, presenting as a nodule, thyroiditis, an abscess, or a carcinoma-like mass. The differential diagnosis from malignancy and other non tuberculous granulomatous lesion is impossible upon the clinical ground. Surgical intervention is essential in order to establish the definitive diagnosis and to exclude the possibility of tumors. We experienced a case of the tuberculosis of the thyroid gland presenting with palpable thyroid nodule in a 44 year-old female patient. She was clinically and biochemically euthyroid and her CT scans demonstrated multiple low density in both thyroid gland with strands in the subcutaneous fat layer. The mass was removed surgically and confirmed to be tuberculosis.
Abscess ; Adult ; Diagnosis ; Diagnosis, Differential ; Epithelial Cells ; Female ; Humans ; Lymphocytes ; Subcutaneous Fat ; Thyroid Gland* ; Thyroid Nodule ; Tomography, X-Ray Computed ; Tuberculosis*

To evaluate a relationship of lumbar lordosis between asymptomatic group and low back pain group, lumbar lordotic angle was measured from standing lateral lumbosacral roentogenogram of 360 men and women between 20 and 49 years of age. We excluded the patients with back deformity, moderate to severe degenerative change of lumbosacral spine, leg length discrepency, and degenerative change of lower leg in both groups. The lumber lordodsis angle was measured with two ways, lumbosacral angle and lumbolumbar angle respectively. Two angles have a line parallel to the top of second lumbar vertebra as the proximal boundary. The distal border of the lumbosacral angle is a line parallel to the top of sacrum. The distal border of the lumbolumbar angle is a line parallel to the bottom of fifth lumbar vertebra. With statistical analysis of the results, we came to followiing conclusion: 1. The mean lumbolumbar angle was 33.62° +0.62° (SEM: standard error of the mean) and the mean lumbosacral angle was 49.91° +0.59° in asymptomatic group. 2. The mean lumbolumbar angle was 34.79° +0.68° and the mean lumbosacral angle was 50.35° +0.76° in low back pain group. 3. No significant difference in lumbosacral and lumbolsacral angle between asymptomatic and low back pain group was identified using general linear models procedure(P>0.5). 4. Analyzing the data by sex, no significant difference in lumbosacral and lumbosacral angle was identified using general linear models procudure(P>0.05). 5. Analyzing the data by age group, no significant difference in lumbosacral angle was identified (P>0.05), but significant difference in lumbolsacral angle was identified using general linear models procedure(P=0.0045).
Animals ; Congenital Abnormalities ; Female ; Humans ; Leg ; Linear Models ; Lordosis ; Low Back Pain ; Male ; Sacrum ; Spine

In 1971, Harris introduced a metal backed acetabular cup to allow replacement of worn polyethylene cups and it has been popularly used now. In metal backed acetabular cup, dissociation between metal shell and polyethylene liner usually occurs with hip dislocation. We report a case of dissociation of polyethylene liner in metal bacded cup not associated with hip dislocation.
Acetabulum ; Hip Dislocation ; Hip ; Polyethylene